Parkinson’s disease in adults

Context

Parkinson's disease is a progressive neurodegenerative condition resulting from the death of dopamine-containing cells of the substantia nigra in the brain. There is no consistently reliable test that can distinguish Parkinson's disease from other conditions that have a similar clinical presentation. The diagnosis is primarily based on a clinical history and examination.

Parkinson's disease is one of the most common neurological conditions. It is estimated to affect up to 160 people per 100,000, with an annual incidence in the UK of 15 to 20 per 100,000.

People with Parkinson's disease classically present with the symptoms and signs described as 'parkinsonism': these include bradykinesia (slow movements), rigidity, rest tremor (shaking) and postural instability (loss of balance).

The symptoms of parkinsonism are not always a result of Parkinson's disease. Other causes include side effects of medicines, vascular disease, and less common degenerative conditions such as progressive supranuclear palsy and multiple system atrophy.

Parkinson's disease has historically been recognised as a primary movement disorder; however, other symptoms may be prominent, such as depression, cognitive impairment and dementia. In the later stages of the disease, people may develop pain and autonomic disturbances (such as dizziness and fainting, and problems with sweating, heart rate, digestion, vision and sexual function). These other symptoms are sometimes described as the 'non-motor' manifestations of Parkinson's disease. The condition may progress to cause significant impairments, adversely affecting quality of life and, indirectly, the quality of life of family and carers.